HomeMy WebLinkAboutBLD2024-00356 - BLD CD Environmental Health Review - 3/15/2024 Pernik No:�%4'
MASON COUNTY MAR 15 2024
COMMUNITY DEVELOPMENT
PamiRAs¢Islanae tamer.6uiMRC HMMarN 615 W. Alder Street
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:wx•a^a°'°°D"^n" NAME-� RISWILL rTj
MAH.ING ADDRESS:2110 EM.mae..a XeIM MAMINGADDRESS:2222a°er RNXE z
CITY... STATE.-A ZIP:° ° CITY:O STATE:M ZIP:oM G
PHONENI PHONE:� CELL: Seolbae2m
PHONE W2: EMAH,:�m — = 0 EMAIL. LAI REG A1°+iK�°rN EXP.OT/ 5
PRUfARY CONTACT: OWNER[] CONTRACTOR❑ OTHER D Z
NAME wnwxuwx EMAIL^+°r"W'm'°r — --I
MAILINGADDRESS 2ma.aW Ra xE CITY anw STATE WA ZN72=°' = rTI
PHONE'N CELL mo-eeeme¢ z
PARCEL INFORMATION:
PARCELNUNIDER(n Di®2Namber) tt+22SMMIY ZONING RRa
LEGALDESCRIPTON(Abbreviatee)—a FIREDISTRICT /Zn
MMAODRESS2110E& Wm MI CIIY°XmL
DIRECTONSTOSOLADDRE93R=^n°^WA'X.TunMmbEMron l.x.Re.Tum Mnomo&awwwwrL vmimm�Wbmm.Xn "y-Y �B
IS THE PROJECT WrI'2@l300 FT OF SIAPF,(S)GREATER THAN I4%: YESO NOR] SNOW LOAD:�sF
c2V�U�Z4
ISPROPERTYWITHEN200FFOFTHEFOLLOWIWG: R'r non unraFpyJ:
SALTWATER❑ LAKEO RIVER/CREERD POND❑ WETLAND[] SEASONALRUNOFF❑ STREAM❑
TYPE OF WORN:: NEW❑ ADDITION 0i ALI'ERADON 0 R x:R❑ oTT R n
USE OF STRUCTURE(xnream rns2s Cw. Br*t )RENOEXCE
IS USE: PRIMARYO SEASONAL❑ NUMBER OF BEDROOMS,?rt NUMBER OF BATHROOMS_
HEATED STRUCTURE? YES/ BkW❑ YES(PaXpJgNkW 0i NO❑
DESCRIBE
SOUARE FOOTAGE:Oemm.el
ISTFLOORIM aq.R. 2NDFLOOR_ubft. 3RDFE00R sq.R. BASEMENT aR.R
DECKM sq.1 COVEREDDECK210 p.R. STORAGE Kit OIIffR sq.R
GARAGEND q.R Atr Wd0 Der lud❑ CARPORT eq.ft Aub d0 D°tt°'2r°d❑
MANUFACTURED HOME INFORMATION: '/COPIES OF THE FLOOR PLAN REQUIRED'
MAKE YEAR LENGTH
BEDROOMS BAnIS
ENVIRONMENTAL HEALTH:
SEWAGFBE'WERSOURCE: SEPTICO SEWER I NEW EXISTINGE]
PLUMBINGMSTRUCTIRE7 YESD NO ((Pm,aach co Vkad Wa AdaOROrPForm
PERIME7ERTOUNDATION DRAMS PROPOSED? YESOi NO EXISTING SQ.FT.
EXISTING BEDROOMS I PROPOSED BEDROOMS + TOTAL BEDROOMS 2 1/
OWNERxbpMeepe NY eWnileebn ginxwreh iMamNm mW raeun In a Mcp rwrx waer a pmnX mwa°m.idvw1e60enwaINeuN 4by
y wmw nebx.laabm MM anmaa es hMaraeNeNab emmrmeamreceive nibreimnene beo mPMMm preppeee.lftm
mhMM v.mL.imnan ql ea neuuery mree¢,mcmtlmN any ae¢amam nome,or pema:ormaren rae=ram°M,s pmbJ me o.ma or hOM
rep®.amlve.revreeenM Mdtla mrormmivn Poaaeo b.rtoga ene Praah emvloyea.q Maeon coenn aora.e ro me aeare eeeoicea vrov.M
mCaffc p mna is InasndW.TabpermHreMd,I tecwne¢null8wlativorkuauVwfizatl cpnalruction IsMmnmervee w+Mln1&1
erya u X¢naNrEm xaak ie euepan°e]Ime pain]q t80 tlay¢.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 190 9AYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
j— COUNTY CODE%0M2)
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SiOnatueN OWMER)Meet be SiQnee bV the OWNER) Oele
InEL 7Ue7S$XIE,..2 . .uPIioR ED nTTE 'TAGS!Ci SPwurnRrvs.�
BUILDING DEPARTMENT
PIANNAIG DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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